Household food consumption patterns in relation to dietary adequacy of vitamin a and iron in Awasi, Nyando district, Kenya
A cross sectional study covering all four sub-locations of Awasi location, in Nyando District was carried out in the months of September -October 2002. A total of304 households were covered by the study. The study aimed at determining the existing food consumption patterns in the area and how they relate to the dietary adequacy of vitamin A and iron. A structured questionnaire was used to obtain information on the socio- demographic characteristics of households, their food production and food purchasing habits and morbidity and sanitation information. Data on food consumption patterns was obtained using a breastfeeding and weaning questionnaire (for young children). A food frequency questionnaire, which incorporated the HKI method of assessing vitamin A adequacy, was done for all households. A 24-hour dietary recall was done in a subsample of3 0 households using instruments for weighing and measuring food. Trained research assistants assisted with data collection. Focus group discussions were held in each sub-location with mothers of index children, to give an in-depth picture of consumption patterns. The female population slightly outnumbered the male population in the households studied and the young population (aged 15 years or younger ), formed more than half of the population (58.6%), compared to those who are 36 years and above who form 13.4% of the population. The average family size was six persons, and the dependency ratio of 148 is higher than both the district ratio (99) and national ratio (92). Household heads were mostly male (88%) and their average age was 37 years. Most household heads have at least some primary education, otherwise the general levels of education attained among household heads is low and very few completed secondary or post secondary education. Generally, fathers were more educated than mothers were. Farm sizes are small, with a mean of 5.4 acres, and far from adequate for food production especially due to low rainfall. Food purchase is the main way of providing food for most households. The foods purchased are mostly basic food items, such as maize, omena, onions and tomatoes and were generally limited in variety. Most households spent between 500-1000 shillings on food each week. Chicken, cows, and goats are the most commonly kept livestock by 50% or more of the households. The morbidity rate among young children is high as indicated by the high incidence of diarrhoea (51.7%), cough (65.3%), and fever (79%), in the four weeks preceding the survey. Water, which is critical for maintaining proper hygiene and avoiding waterborne diseases, is limited in both quantity and quality. Toilets, essential for hygiene were non-existent in almost half(47.5%) of the study households. More than 50% of the index children (aged 3 years or less) were still being breastfed at the time of the study. The mean duration ofbreastfeeding was 2.7 months. Cows' milk was commonly used to supplement breast-milk. Most of the children (84%) had already been weaned. Common weaning foods included maize-meal porridge, ugali, fish and dark-green leafy vegetables. General food consumption patterns show limited variety in the foods eaten, these include ugali, fish( mainlyomena)-:--ail-d dark green leafy vegetables There is a limited consumption of fruits and animal meats. Food is mostly prepared by boiling or stewing. When food is fried very little fat is used. Both the food frequency and 24-hour dietary recall show inadequate consumption of vitamin A by household members. The calorie intake is below the recommended requirement for most households. Due to the culture of eating omena (dagaa) in the area the iron and protein intake appears adequate in most or all households. However the bioavailability of these essential nutrients is low, due to diseases such as malaria, diahorrea, and rnv. There is also low consumption of vitamin C rich fruits necessary for iron absorption. The result is a high prevalence of vitamin A and iron deficiency disease, as well as rampant malnutrition. Food-based interventions aimed at providing adequate vitamin A and iron should focus on integrated methods that will provide adequate vitamin A rich foods and increase the bio-availability of iron in foods. Supplementation is a short term remedy to the problem. Food based approaches offer greater potential of being long term and can be maintained by the community. Since they are based on current consumption patterns they don't require great changes. This can be done by the promotion of agricultural practices which increase production and consumption of indigenous vegetables, beans and the orange fleshed sweet potatoe among others. Livestock farming can be improved and expanded for both domestic consumption and sale. Nutrition education and endemic disease control programmes must be an essential part of the interventions.